One of the myriad things presidential contender Mitt Romney has pledged to do on day one of his presidency is to repeal the Affordable Care Act, President Obama’s signature health care reform legislation, and replace it with “market drive” reforms. But a new study estimates that the effort would actually increase the number of uninsured Americans to 72 million and increase costs across the board.
The Commonwealth Fund report considered Romney’s proposal in full, including his plans to transform Medicare into a “premium support” structure and convert Medicaid into a block grant for the states. Romney would also “equalize the tax treatment of employer-based coverage and plans purchased in the individual insurance market,” allow insurance companies to circumvent state-based consumer protections to sell subprime plans “across state lines,” and push sicker Americans into expensive high-risk pools. The changes will make it harder for the 129 million Americans with pre-existing conditions to find coverage.
As a result, 72 million Americans would be unable to obtain insurance — more than if the Affordable Care Act had not become law in the first place:
Out-of-pocket spending and premiums would also increase, since Americans would lose “the combination of premium tax credits, limits on out-of-pocket spending, and consumer protections” that will reduce “costs for people purchasing coverage through the new insurance exchanges or the individual market”:
Romney’s plan would hit young adults between the ages of 19 and 29 the hardest, with an estimated 41.4 million uninsured (PDF) under his plan. That contrasts sharply to Obama’s health care reform, which will drop the uninsured in that age group down to 16 million, mainly thanks to the provision allowing adults up to 26 years old to remain on their guardians’ insurance.
The Republican candidate’s plan would also be particularly tough for low-income people or people living in poverty, who, under Obamacare, will be eligible for coverage in most states through the expansion of the Medicaid program. With Romney’s cuts to Medicaid, however, the number of uninsured people within 138 percent of the federal poverty line would grow from a baseline of 38.6 million to 43.7 million.